Hey everyone! In this lesson we are going to talk about the process of helping our adolescent patients transition from pediatric care to adult care, and we’ll do this by thinking about the developmental needs that are specific to this age group.

So, this process of changing care, leaving pediatric settings and moving to an adult provider can be very stressful for an adolescent patient who has been dealing with a complicated illness.  they will have developed a high level of comfort in the peds world.

Now, adolescent patients are already at risk for non-compliance because developmentally, they feel invincible.  They don’t fully comprehend the impact their illness could have if not properly managed. In addition to this, our adolescent patients are going to be super concerned about their peer groups.  They want to be popular, and cool and normal so they may be less compliant if they think it’s going to affect this.

So, yeah transitioning to adult medicine is difficult and should involve a lot of planning.  Nurses play a huge role in this process.

Some diagnoses where this is a common issue are cystic fibrosis, asthma, sickle cell disease, and bleeding disorders

The first thing nurses do is help assess to see if the patient is ready to transition.

The first thing we are looking for is to see that the patient is currently adhering to their management plan- so they are taking their medications, attending appointments, complying with diets, and generally have a solid understanding of the disease process.

Next, we want to see that as a result of their adherence, their disease has stabilized.  So they way we measure this will vary with each disease, but we would want to see infrequent hospitalizations, fewer exacerbations of the illness, a lack of infections.  All the things that would indicate they are managing the disease well.

We also want to see them stepping up and being involved in the care.  So not just adhering to the plan, but also helping to create a plan that works for them.  So this could mean scheduling appointments, taking time to read about their illness, things like that

Last but not least, we want to see that they are achieving a good quality of life.  They have friends, they can set and attain goals, and that they are meeting milestones as well.

Like I said, nurses are really involved in this process.  The encounters you have with these patients, either in hospital or at appointments are perfect times to chat about how they are feeling and also to involve them in the care.

 It really boils down to communication, planning and patient education.  These are pretty self-explanatory. You really want to make sure you give ample opportunities for the patient to be involved and make decisions from early on so they are ready to make the transition when they need to.

Once the transition has been made, they need to be under close monitoring and someone should be reassessing to make sure they are managing well and remain compliant with their care plan.

Peer groups can be really helpful during this time as they can help build confidence and ultimately help the patient stick with the care plan.